Mary Harney (Dublin Mid West, Progressive Democrats)

I will start with the cleaning issue, if that is in order. We now have had three audits and to be fair to the last audit, it was much wider than the issue of cleaning. I have a quotation, which I will not bore Members by reading, but it complimented the hospitals on the hygiene issue but where they fell down was in risk assessment and taking the issue seriously at corporate governance level. If something cannot be measured, it cannot be managed. The fact that we now have an independent authority and that all of this data come into the public arena puts enormous pressure on people to perform. The audits are unannounced.

Regarding cleaning and the other two audits, whether they were insourced or outsourced, a new building or an old building, whether they had microbiologists or did not, there was no correlation. In the first audit Mallow hospital came number one. It had no microbiologist, it is very old and it had in-house cleaning. St. James's Hospital did very well; it was top of the class. It had outsourced some of its cleaning and insourced other aspects. If hospitals are outsourcing and buying in a service, they pay only for what they buy. In-house or out-house is not the issue. There are wider issues to do with how seriously the issue is taken. I have said previously and repeat now that in my previous job as Minister for Enterprise, Trade and Employment, if one went to Intel in Leixlip one was gowned from head to toe. I am not suggesting everybody going into a hospital should be gowned but one would not get near one of those semi-conductor chips inside the glass if one was not covered from head to toe. We must take seriously uniforms, visitors and so forth. In many of the world's best hospitals, there can be no more than two visitors per patient. I have seen hoards of people, sometimes bringing in take-aways, around four or six patients in wards. Hospital management should take seriously these matters, as this is not just Big Brother Minister saying something. A hospital is a place where there are many sick people. If they are not sick, they should be in alternative facilities.

Concerning St. Luke's General Hospital, every expert told us that a stand-alone radiotherapy hospital was not a good idea and that there must be multidisciplinary care where radiation, medical oncology and surgery are brought together. The decision was made to move the cancer treatment facilities at St. Luke's General Hospital to St. James's Hospital. Until recently, virtually everyone who received radiation oncology treatment undertook it at St. Luke's General Hospital. There is a significant attachment to the professionalism, the place and the staff. We want to keep the ethos in St. James's Hospital, an assurance I have given to the board of St. Luke's General Hospital.

The facilities at St. Luke's General Hospital have 150 beds, but there are 40 in British Columbia. When there are facilities in the centres outside Dublin, some of the people who would otherwise have gone to St. Luke's General Hospital may not need to travel to Dublin. Many must travel up on Sunday and return on Monday morning or Friday. Others would be more appropriately accommodated in a hotel or the like instead of a hospital-type facility.

These are the kinds of actions Professor Keane undertook in Canada and that I hope he will undertake here. The plan involves the Irish Cancer Society and Europa Donna, in which Senator Fitzgerald is involved. Patient groups, not just clinicians, were at the heart of the plan.

Dr. Crown is an excellent clinician and a world leader in his field. Memorial Sloan Kettering Cancer Centre, which I visited shortly after becoming the Minister for Health and Children, commended the fact that he was one of the two best doctors to have gone through it. I met him regarding a certain matter shortly after becoming the Minister, after which our relationship seemed to fall apart. I am not the one to bring him on board. He has strong opinions on my politics and I, but Professor Keane will bring him on board because we need people like him.